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Table 2 Success stories of pharmacist intervention around the world in combating AMR from recently published articles

From: Enhancing pharmacists’ role in developing countries to overcome the challenge of antimicrobial resistance: a narrative review

Authors Country Setting Objective Study design Type of intervention Relevant outcomes
Brink et al., 2017 [97] South Africa Hospital To implement an improvement model for existing resources, in order to achieve a reduction in surgical site infections (SSIs) across a heterogeneous group of 34 urban and rural South African hospitals A pharmacist-driven, prospective audit and feedback strategy Pharmacist included in the post-pharmacist intervention pharmacists can effectively improve guideline compliance and sustainable patient
outcomes(P < 0.0001)
Ellis et al., 2016 [36] USA Hospital To assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric unit Pre and Post - pharmacist intervention Pharmacist included in the post-pharmacist intervention Post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (p = 0.02), pharmacist intervention group had less antibiotics prescribed for an inappropriate duration(p < 0.01), post intervention group had medications prescribed with appropriate dose, duration, and indication(p = 0.04)
Okada et al., 2016 [37] Japan Hospital To investigate the clinical effectiveness of the pharmacist interventions on antibiotic use Retrospective study design Pharmacist included in the intervention group Effective drug concentrations significantly increased in the intervention group. Intervention (74%) and control (55%).
Northey et al., 2015 [38] Australia Community To assess the effectiveness of involving community pharmacy staff in patient education about antibiotic resistance Randomized control study Those in the intervention group were provided with verbal education by pharmacists Antibiotic knowledge increased after receiving verbal antibiotic education (p = 0.008)
Zhou et al., 2015 [34] China Hospital To describe the impacts of pharmacist intervention on the use of antibiotics, particularly in urology clean operations Pre and Post - pharmacist intervention Pharmacist included in the post intervention group Average antibiotic cost decreased, cost of antibiotics as a percentage of total drug cost decreased by 27. 7%; the rate of use of antibiotics decreased from 100% to 7.3%
Booth et al., 2013 [10] UK Community To compare the care pathway of patients with UTI symptoms attending GP services with those receiving management, including trimethoprim supply under PGD, via community pharmacies Prospective, cross-sectional, mixed methods Pharmacies invited a purposive sample of female patients to participate Antibiotic treatments for UTIs could be provided via community pharmacy to improve patient access to treatment which may also maintain antibiotic stewardship and reduce GP workload
Magedanz et al., 2012 [9] Brazil Hospital To assess the impact of ASP, with and without the presence of a pharmacist, in a cardiology hospital in Brazil Pre and Post pharmacist intervention Pharmacist included in the post-pharmacist intervention Adherence to recommendations was increased (64%), hospital antibiotic cost reduction (69%).
Yen et al., 2012 [39] Taiwan Hospital A pharmacist-managed antibiotic intravenous to oral (i.v.-to-p.o.) conversion program has been incorporated to minimize unnecessary i.v. antibiotic usage Retrospectively collected by chart review Pharmacist included in the intervention group Length of hospital stay was significantly decreased (p = 0.001)
Dunn et al., 2011 [40] Ireland Hospital To assess the impact of the introduction of guidelines and criteria for switching to oral antimicrobials prospective and of controlled before and after design Pharmacist included in the intervention group Duration of IV antimicrobial treatment reduced significantly in the study group post intervention, (P = 0.02) compared to the control group
Grill et al., 2011 [41] Germany Hospital To assess the impact of pharmaceutical consulting on the quality of antimicrobial use in a surgical hospital department Prospective controlled intervention study Pharmacist included in the intervention group Intervention reduced the length of antimicrobial courses (IG = 10 days, CG = 11 days, incidence rate ratio for i.v. versus o.p. = 0.88, 95% confidence interval 0.84 to 0.93) and shortened i.v. administration (IG = 8 days, CG = 10 days, hazard rate = 1.76 in favour of switch from i.v. to p.o., 95% confidence interval 1.23 to 2.52).
95% confidence interval 1.23 to 2.52
Shen et al., 2011 [35] China Hospital To evaluate the impact of pharmacist interventions on antibiotic use in inpatients with respiratory tract infections in a tertiary hospital in China Randomized control study Pharmacist included in the intervention group, no pharmacist in the control group Total costs of hospitalization in the intervention group was lower compared to the control group P < 0.001. Total cost of antibiotics in the intervention group was lower to the control group (P = 0.01). Patients required shorter length of hospital stay (P = 0.03)
Hersberger et al., 2009 [42] Switzerland Community To examine prescribing patterns of antibiotics and symptomatic medications for ARTI in Swiss primary care and to monitor pharmacists’ interventions during the prescription-dispensing process Cluster randomized trial Pharmacist included in the intervention group Most patients (80%) were treated only with symptomatic medications. Most frequently prescribed symptomatic ARTI medications were nasal decongestants (39%), cough suppressants (36%), and mucolytic (31%)
  1. ASP: Antimicrobial Stewardship Program, UTI Urinary Tract Infection, ARTI Acute Respiratory Tract Infection, IV Intravenous
  2. GP: General Physician, PGD: Prescribing guidelines